摘要目的 探讨非小细胞肺癌(NSCLC)表皮生长因子受体(EGFR)酪氨酸激酶基因编码区第19和21外显子突变阴性患者的化疗疗效.方法 140例NSCLC患者分为EGFR突变阴性组和EGFR突变阳性组,均采用吉西他滨或长春瑞滨加顺铂或卡铂化疗.结果 EGFR突变阴性组患者中,部分缓解(PR)26例,疾病稳定(SD)48例,疾病进展(PD) 16例,疾病控制率82.2％；EGFR突变阳性组患者中,PR 14例,SD 23例,PD 13例,疾病控制率74.0％；两组患者的疾病控制率差异无统计学意义(P =0.250).EGFR突变阴性组和EGFR突变阳性组患者的无进展生存时间(PFS)分别为4.2个月(95％ CI为3.8 ～4.6个月)和4.0个月(95％ CI为3.6 ～4.4个月),差异有统计学意义(P=0.021).EGFR突变阴性组和EGFR突变阳性组患者的总生存时间(OS)分别为9.2个月(95％ CI为8.4～10.0个月)和7.8个月(95％ CI为6.9～8.7个月),差异有统计学意义(P =0.028).结论 化疗能延长EGFR突变阴性患者的PFS和OS,但仅OS延长上有实际意义.

abstractsObjective To evaluate the efficacy of chemotherapy for patients with EGFR (exon 19 and 21) mutation-negative non-small cell lung cancer (NSCLC).Methods One hundred and forty NSCLC patients with negative EGFR mutation (90 cases) or EGFR mutation (50 cases) underwent gemcitabine or vinorelbine plus cisplatin or carboplatin chemotherapy.Results In the EGFR mutation-negative patients,there were PR in 26 cases,SD in 48 cases,PD in 16 cases,the disease control rate was 82.2％.In the patients with EGFR mutation,there were PR in 14 cases,SD in 23 cases,PD in 13 cases,the disease control rate was 74.0％.The difference of disease control rates in the two groups was not significant (P =0.250).The progression free survival (PFS) of EGFR mutation-negative patients was 4.2 months (95％ CI 3.8-4.6) vs.4.0 months (95％ CI 3.6-4.4) in patients with EGFR mutation,with a significant difference (P =0.021).The overall survival (OS) of EGFR mutation-negative patients was 9.2 months (95％ CI 8.4-10.0) vs.7.8 months (95％CI,6.9-8.7) of patients with EGFR mutation (P =0.028).Condusions Chemotherapy can prolong the PFS and OS of EGFR mutation-negative patients.However,only the extension of OS has practical significance.